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Kidney Week

Abstract: TH-PO279

Challenges to Hemodialysis Care and Solutions: Qualitative Analysis of the Can-SOLVE CKD Triple I Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Bohm, Clara, University of Manitoba, Winnipeg, Manitoba, Canada
  • Rossum, Krista Frances, University of Manitoba, Winnipeg, Manitoba, Canada
  • Finlay, Juli, University of Calgary, Calgary, Alberta, Canada
  • Desjarlais, Arlene Diana, Can-solv CKD, Winnipeg, Manitoba, Canada
  • Mccormick, Michael D., CanSolve CKD, Toronto, Ontario, Canada
  • Pannu, Neesh I., University of Alberta, Edmonton, Alberta, Canada
  • James, Matthew T., University of Calgary, Calgary, Alberta, Canada
  • Tennankore, Karthik K., Dalhousie University/NS Health Authority, Halifax, Nova Scotia, Canada
  • Sood, Manish M., Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  • Thompson, Stephanie E., University of Alberta, Edmonton, Alberta, Canada
  • Tonelli, Marcello, University of Calgary, Calgary, Alberta, Canada

Part of the Can-SOLVE CKD program, ‘Triple-I’ is a pan-Canadian study that aims to identify top priorities and test solutions for improving patients’ hemodialysis (HD) experience in three areas: a) Information patients receive b) Interactions between provider and patient c) Individualization of care. Triple-I follows Can-SOLVE’s guiding principles to involve patients in all phases of research as co-creators of knowledge and solutions.
In Phase 1, using focus groups and interviews, we identified challenges in HD care and potential solutions in the areas of information, interaction and individualization.


From July 1, 2017 to July 31, 2018, we performed focus groups and interviews with HD patients, their caregivers and healthcare providers in 5 academic centres (Edmonton, Calgary, Winnipeg, Ottawa and Halifax). Subsequently, 3 members of the research team conducted a pragmatic categorical analysis to code the data from de-identified transcripts of these sessions. Data were classified by respondent type (patients/caregiver or health care providers).


A total 113 people (64 HD patients, 18 caregivers, 31 health care providers) participated in 8 focus groups or individual interviews, of which 41% were women. Mean age of patients and caregivers was 61 years and mean time on HD was 4.6 years.
After accounting for redundancy, a total of 45 recurring challenges in HD care were identified (information n=18; interaction n=16; and individualization n=11). Highly prevalent challenges included information on modality/access, transplant and first day of HD; interactions with nephrologists, nurses and inconsistency of care with different healthcare providers; and, insufficient individualization of session set-up, transportation arrangements and ways to address socio-economic and emotional well-being. Although there were some differences in responses between patients/caregivers and health care providers, many of the challenges coded were identified by both groups.


Although a deeper qualitative analysis of this data is ongoing, the codes/challenges identified in this phase of the study will be used to prioritize challenges and identify and test potential solutions to these challenges in further phases of the study.


  • Government Support - Non-U.S.